AB0235 ANALYSIS OF FACTORS AFFECTING FATIGUE IN PATIENTS WITH RHEUMATOID ARTHRITIS - TOMORROW STUDY-
Authors: H. Yoshimura, T. Koike, Y. Sugioka, T. Okano, K. Mamoto, M. Tada, K. Inui, H. Nakamura
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Great advances have been made in the treatment of rheumatoid arthritis (RA), and remission has become a viable target. However, some patients complain of fatigue even in remission. <h3>Objectives</h3> The purpose of this study was to investigate whether RA patients are more likely to experience fatigue than the general population, and to clarify the factors involved in the formation of fatigue. <h3>Methods</h3> We analyzed data from the TOMORROW study (UMIN000003876) study, which is a 10-years prospective cohort consisting of age and sex matched RA patients (n=208) and volunteers (Vo) (n=205). We conducted a QOL survey using SF-36 in 2019. Fatigue was assessed using the vitality component (VT) of the SF-36. First, each scale of SF-36 was compared between RA patients and Vo, and the effects of RA on fatigue and QOL were evaluated by multiple liner regression analysis. Next, we limited the target to RA patients and tried to identify the factors involved in fatigue. We included anthropometric measurements parameters, disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR), RA medication (methotrexate (MTX) dose, prednisolone dose, use of biologic disease modifying anti-rheumatic-drugs (bDMARDs)), tender joint count, swelling joint count, VAS and modified Health Assessment Questionnaire (mHAQ) as candidate factors. <h3>Results</h3> Subjects were 186 Vo and 167 RA patients in 2019. In RA, average age was 65.8 ± 12.7 year, 143 patients (85.6%) were female, average disease duration was 13.8 ± 11.8 year and DAS28-ESR was 3.10 ± 1.45. Compared with Vo, Physical Component Summary (PCS) (Vo 46.9 ± 12.2, RA 34.1 ± 18.0: p&lt;0.01), Mental Component Summary (MCS) (Vo 52.2 ± 9.5, RA 49.4 ± 9.5: p&lt;0.01) and VT (Vo 50.5 ± 10.1, RA 44.0 ± 10.8: p&lt;0.01) were significantly lower in RA patients. In multiple liner regression analysis, RA was a significant decreasing factor of PCS (β -12.8, 95%CI -15.7 - -9.89: p&lt;0.01), MCS (β -2.75, 95%CI -4.68 - -0.82: p&lt;0.01) and VT (β -3.01, 95%CI -4.57- -1.45: p&lt;0.01). In RA patients, multiple liner regression analysis shows that VAS (β -0.06, 95%CI -0.12 - -0.00: p=0.03), ESR (β -0.09, 95%CI -0.16 - -0.02: p=0.02), and mental health component of the SF-36(MH) (β 0.55, 95%CI 0.42 – 0.68: p&lt;0.01), were significant affecting factor for VT. (Table 1) <h3>Conclusion</h3> In this study, RA was a significant QOL declining factor. High VAS score, high ESR values and low mental health score were associated with fatigue in patients with RA. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Hitoshi Yoshimura: None declared, Tatsuya Koike Consultant of: AbbVie, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical, Pfizer, Roche, Takeda Pharmaceutical, Teijin Pharma, and UCB., Grant/research support from: AbbVie, Astellas Pharma Inc., Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical, Pfizer, Roche, Takeda Pharmaceutical, Teijin Pharma, and UCB., Yuko Sugioka: None declared, Tadashi Okano: None declared, Kenji Mamoto: None declared, Masahiro Tada: None declared, Kentaro Inui: None declared, Hiroaki Nakamura: None declared.